Eye Health Questions (NCLEX 56-60)

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56. A scleral buckling procedure is performed on a client with retinal detachment, and the nurse provides home-care instructions to the client. Which statement by the client indicates a need for further instructions?

a) I need to avoid heavy lifting
b) I need to avoid vigorous activity
c) I need to wear an eye shield during naps and at night
d) I need to clean the eye daily with sterile water ad a clean washcloth

57. The nurse is providing instructions to a client and family regarding home care after left-eye cataract removal. The nurse tells the client and family which of the following about positioning during the postoperative period?

a) sleep only on the left side
b) sleep on the right side or the back
c) bend below the waist as often as you are able
d) lower the head between the knees three times a day

58. A client has undergone surgery for glaucoma. The nurse provides which discharge instructions to the client?

a) the sutures are removed after 1 week
b) wound healing usually takes 12 weeks
c) expect that vision will be permanently impaired
d) a shield or eye patch should be worn to protect the eye

59. A client has undergone surgery for cataracts. The nurse instructs the client to call the physician for which of the following complaints?

a) a sudden decrease in vision
b) a gradual resolution of eye redness
c) eye pain relieved by acetaminophen (Tylenol)
d) small amounts of dried matter on the eyelashes after sleep

60. A client is seen in the health care clinic, and a diagnosis of conjunctivitis is made. The nurse provides instructions to the client regarding the care of the disorder while at home. Which statement by the client indicates the need for further instruction?

a) I can use an ophthalmic analgesic ointment at night if I have eye discomfort
b) I do not need to be concerned about spreading this infection to others in my family
c) I should apply warm compresses before instilling antibiotic drops if purulent discharge is present in my eye
d) I should perform a saline eye irrigation before instilling the antibiotic drops into my eye if purulent discharge is present

Eye Health Questions
Answers and Rationale

56) D
- In a scleral buckling procedure, the sclera is compressed from the outside by Silastic sponges or silicone bands that are sutured in place permanently. In addition, an intraocular injection of air, a gas bubble, or both may be used to apply pressure on the retina from the inside of the eye to hold the retina in place. If an air or gas bubble has been injected, it may take several weeks to be absorbed. Vigorous activities and heavy lifting are avoided. An eye shield or glasses should be worn during the day, and a shield should be worn during naps and at night. The client is instructed to clean the eye with warm tap water using a clean washcloth.

57) B
- After cataract surgery, the client should not sleep on the operative side. The client should also avoid bending below the level of the waist or lowering the head, because these actions will increase intraocular pressure.

58) D
- After ocular surgery, the client should wear an eye patch or eyeglasses for the protection of the eye. Healing takes place in about 6 weeks. When the postoperative inflammation subsides, the client's vision should return to the preoperative level of acuity. Sutures are usually absorbable.

59) A
- The client should report a noticeable or sudden decrease in vision to the physician. The eye may be slightly reddened postoperatively, but this should gradually resolve. The client is taught to take acetaminophen, which is usually effective for relieving discomfort. Small amounts of dried material may be present on the lashes after sleep; this is expected and should be removed with a warm facecloth.

60) B
- Conjunctivitis is highly contagious. Antibiotic drops are usually administered four times a day. Ophthalmic analgesic ointment or drops may be instilled, especially at bedtime, because discomfort becomes more noticeable when the eyelids are closed. When purulent discharge is present, saline eye irrigations or applications of warm compresses to the eye may be necessary before instilling the medication.

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Eye Health Questions (1-6)

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Eye Health Questions (61-65)